A trio of reports on protocols for reducing rates of central line-associated bloodstream infections was among the highlights of the annual conference of the Association for Professionals in Infection Control and Epidemiology.
Some 2,500 clinicians specializing in infection control left the 41st annual conference of the Association for Professionals in Infection Control and Epidemiology this week with better knowledge of hand washing guidance, the importance of healthcare worker influenza vaccination, and the prevention of central line-associated bloodstream infections.
The APIC conference, which convened in Anaheim, CA June 7–9, drew a record 4,170 attendees including exhibitors, and 2,514 clinicians, an APIC spokeswoman said.
Port Protectors
Three reports made CLABSI prevention a key theme at the conference. One, from Texas Health's Barbara Danielson, found that use of alcohol-impregnated port protectors helped reduce infection rates. Even though line insertion practices were correct, "13% (of the) staff did not scrub the hub of the catheter with alcohol for a full 15 seconds before accessing."
The hospital had seen a 40% decrease in CLABSI rates in 2011 after implementation of alcohol-coated port protectors, so preventionists decided to expand it throughout the hospital. After the first 10 months, they saw a 68% reduction compared to the previous 10 months without the use of alcohol on port protectors.
"This process improvement step was significant in reducing house-wide CLABSIs, as well as increasing staff satisfaction and impacting cost," the author wrote in the abstract.
Intravenous Ports
In another paper, Marcelina Wawrzyniak, an infection preventionist from Loyola University Medical Center, and colleagues, found that routine use of sterile, single-use disinfecting devices containing isopropyl alcohol that attach to intravenous ports found similar success over two years.
"We noted a 68% decrease in the overall number of CLABSIs with 59 CLABSIs during the 12-month standard care period vs. 23 CLABSIs during the 12-month intervention period," or 36 fewer infections "than would have been expected had usual care continued," she wrote in her abstract. "Pediatric units also had substantially decreased CLABSIs."
She added that if the CDC's estimates of CLABSI's cost per infection were used, $29,166, preventing those 36 CLABSIs saved more than $ 1million over the first year of the intervention.
A Toolkit for Scrubbing the Hub
Jenny Bender, an infection preventionist at UPMC St. Margaret, a 250-bed hospital near Pittsburgh, said that the hospital had seen low or zero CLABSIs over time. But when staff stopped using alcohol impregnated line caps because of a change in the healthcare system's procedures, in January, 2013, they saw CLABSI rates doubling as high as 2.27 line infections per 1,000 patient days by April, 2013.
The remedy included distribution of a toolkit for scrubbing the hub. Proper labeling, dressing and tubing to prevent CLABSI was distributed, along with pocket cards to all units. A care manual was posted online so that staff could access it any time.
As of June 2013, infection rates for CLABSI were back down to zero, and stayed that way through November, Bender reported.
"Sometimes infection control technology, although helpful, can mask clinical practice problems. When our health system discontinued swab caps, we found an opportunity to improve our nursing practice and decreased CLABSIs with basic line care."